Sunday, May 10, 2015

When ever I get the opportunity to help the bedside nurse with end of life care I feel I am actually doing what I was intended to do with my career. I am so honored that the nurse feels comfortable calling me. My latest request occurred last Friday. The nurse was just given a consult for EOL care with my group. She wanted me to stop by and see if there was anything else I could suggest. The patient was a 28 year old man with ALL who developed a fungal infection in his sinuses that spread to his brain and was now actively dying. The family agreed to a DNR status and seemed to be coping well. I was able to adjust the current orders and write for some back-up orders in case they would be needed over later. I love asking the nurse what other orders they want. They always look so surprised and they seem to enjoy being part of the decision process. We settled on adjusting the Morphine drip, adding orders for Glycopyrrolate, and increasing the Ativan order to 0.5mg q 2 hours prn. I spoke to the family and answered their questions. I taught them what to expect to see when their son's death was eminent, the importance for them to get their rest, the fact that the dying chose their time and to not take it as a failure if he dies when they are not there, and that the family was in charge and could dictate when their son was to be turned and if they want him bathed. I emphasized that this was their time with their son and it was precious. We talked about the use of music and familiar sounds. At this point their son was hypersensitive and rested better with silence. The family liked the idea of aroma therapy and went to the gift shop to purchase some lavender scented lotion. I went over some additional teaching points with the nurses and earned some Brownie points with my Docs for starting a consult for them. It is interesting how I need to be needed as much as the nurse and family needed me.